Airway First

Airway management and sleep medicine are relatively new areas of specialization when it comes to the practice of dentistry. Although some dentists have made providing therapy in these areas a prominent focus of their practices and revenue generation, the more that we learn about the effects of our treatments on our patients' ability to breathe and overall health, the more apparent it becomes that all restorative dentists need to increase their education regarding the relationship between the airway and dental treatment. Like the establishment of proper occlusion, the patency of a patient's airway needs to be considered and controlled prior to undertaking any restorative treatment, especially major reconstructions.

Historically, restorative dental treatments have primarily been driven by the pursuit of excellent esthetics; however, the evidence is now showing us that some of these treatment approaches have had a negative impact on our patients' airways. When performing complex restorations or orthodontics, clinicians shouldn't be "thinking outside of the box," but rather, "thinking about making the box bigger." Instead of utilizing techniques that reduce the oral cavity space, even if they are otherwise more efficient, clinicians should be pursuing techniques that maintain or expand the arches.

Regarding the provision of appliance therapy for sleep-disordered breathing, it is imperative to assemble a collaborative team of players, including a physician who is certified in sleep medicine, to ensure that the therapy doesn't merely stop the snoring without curing the apnea. Quality education is required-and more than just a weekend course.

To broaden your understanding of the importance of airway in dentistry, this month's cover story provides an overview of airway considerations in restorative dentistry and discusses airway management. Addressing infection control, our June continuing education article examines ways to improve your infection prevention program by optimizing the use of infection control products. Other articles in this issue discuss tips for determining the most appropriate approach to whitening treatment and coding it in a cost-efficient manner and factors beyond prognosis to consider when deciding between single- and multiple-visit root canal therapy. And be sure to check out the highlights from Season 2 of Product Talk, a multimedia resource from Inside Dentistry in partnership with Aegis TV that features in-depth peer-to-peer discussions about featured products.

I hope that you enjoy the issue. As always, your insights and feedback are welcome. Feel free to contact me at the address below-I look forward to hearing from you!

Robert C. Margeas, DDS
Editor-in-Chief, Inside Dentistry
Private Practice, Des Moines, Iowa
Adjunct Professor
Department of Operative Dentistry
University of Iowa, Iowa City, Iowa
rmargeas_eic@aegiscomm.com